Judge rejects Illinois hospital's attempt to fire doctor

A judge has rebuffed an attempt by Northwest Community Hospital, Arlington Heights, Ill., to revoke the admitting privileges of one of its surgeons, a new obstacle for hospital CEO Bruce Crowther, whose relationships with some physicians have already shown signs of fraying.

A Cook County Circuit Court judge has issued a preliminary injunction barring the hospital from terminating Dr. Yelena Levitin, a member of the medical staff since 2000.

In November Dr. Levitin sued the hospital. In her complaint she paints an unflattering portrait of the 496-bed hospital, whose administration allegedly yielded to efforts by rival surgeons to force her out in order to bolster their own practices. The hospital also retaliated because she planned to open a competing outpatient surgery center only four miles from its campus, which Northwest Community publicly opposed, the complaint alleges.

The hospital disagrees with Dr. Levitin's allegations, but declines to comment further because the case is pending, a spokeswoman said.

The legal setback is yet another challenge for Mr. Crowther, who had to cut more than 200 jobs in two rounds of layoffs in 2012, faced the abrupt departure of the hospital's chief medical officer in June, and then faced criticismfrom a well-known member of the medical staff over the procedure to hire a replacement.

Physicians on the medical staff are not hospital employees. Instead, the relationship — including a doctor's admitting privileges — is governed by hospital bylaws. Dr. Levitin's privileges were challenged during a complicated set of internal reviews in which a key rival, surgeon Dr. William Soper, played an important role. Dr. Soper, the current vice president of Northwest Community's medical staff, declined to comment through the hospital spokeswoman.

If true, Dr. Levitin's allegations highlight the jumbled ethics that can arise in physician peer-review, a process which at best can provide a framework for professional improvement and at worst can turn clannish and vindictive.

“Medical staffs often have a tremendous problem recognizing conflicts of interest and dealing with it in an ethical manner,” said Dr. Robert Marder, a health care consultant who specializes in medical staff issues and quality improvement, who is not involved in the case. “The culture tends to be collegial and interactive, but it tends to bite them when it comes to making formal decisions.”

Ultimately, the hospital's medical executive committee voted to terminate Dr. Levitin not because of the quality of her care, but because it did not believe she would “take a more professional approach toward her colleagues and adopt a team approach,” the complaint says.

For two years, Dr. Levitin was subjected to pattern of harassment by another surgeon, Dr. Daniel Conway, Dr. Soper's business partner, the complaint says. In January 2010, Dr. Soper lodged a request with the medical staff executive committee for corrective action against Dr. Levitin, questioning her handling of 30 cases, the complaint says. An investigation later found no action was necessary, according to her lawsuit.

“It was anticompetitive from the beginning,” Dr. Levitin, a 1995 graduate of Northwestern University's Feinberg School of Medicine, said in an interview.

Another complaint was made in September 2011 by Dr. Francis Lamberta, then-president of Northwest Community's medical staff, questioning her handling of another case.

This time, the medical executive committee voted to terminate her privileges. In October a hospital-appointed judicial review committee reversed that decision, saying the medical staff hadn't met the standards for proving Dr. Levitin should be removed, the complaint states. Dr. Lamberta declined to comment.

But that decision was overruled by the hospital quality committee after an appeal from the medical executive committee. On Nov. 20, the hospital board voted to affirm the termination, and Dr. Levitin sued the hospital a day later.

On Dec. 17, Circuit Court Judge Mary Anne Mason issued the preliminary injunction against the hospital, saying Dr. Levitin had shown a "likelihood of success" on her claim that the hospital had violated its medical staff bylaws and state law in allowing the medical executive committee to appeal, according to the text of the order.